Despite this growing consensus on the magnitude of the problem, Canadian health research seems extraordinarily slow to respond. A search of the Canadian Research Information System—a database of grants and awards funded by multiple agencies and foundations—reveals that since 2009, only 55 of 28,752 funded grants and awards by CIHR (the main health research funding body in Canada) included the term “climate change” in their abstracts. This represents just 0.2 percent of total awards.

As co-authors of this piece, we are a diverse group: a family physician, an emergency room physician, a health research statistician, and a health economist. But we all share a heightened sense of worry about the growing impact of climate change on health, and the dearth of Canadian research related to this.

It’s possible that health researchers “don’t know what they don’t know” on the topic: Climate change is still not covered in the vast majority of medical and nursing school curricula, and many health professionals have yet to make the connections between climate change and health. Researchers may also be daunted by the scope and scale of the problem.

A recent survey by the Institute of Health Policy, Management and Evaluation at the University of Toronto suggests this is the case. The survey of 205 faculty, students, clinicians, researchers, administrators and others working in the health sector found that although 61 percent indicated an interest and willingness to include climate change and environmental sustainability in their programs of research, a majority were not currently doing this. Respondents identified lack of knowledge about the link between climate change and health, lack of awareness of research priorities, lack of collaboration opportunities related to climate change and health research, and lack of funding as key barriers.

Science has an essential role to play in informing our understanding of anticipated health impacts and in guiding policy for mitigating climate change. These health impacts include increasing heat-related illnesses such as heat stroke and death; floods and wildfires associated with stress and displacement from disasters; climate-change related expansion of vector-borne infectious diseases (including Lyme Disease); warmer temperatures resulting in higher pollen levels and a greater burden of allergy-related illnesses; and the increase in wildfire-related air pollution causing more frequent and severe asthma exacerbations.

Another related area of relevance in Canada is research on the human health impacts of unconventional extraction of fossil fuels. Fracking (or hydraulic fracturing) is a mining process that involves drilling holes vertically and then horizontally into the ground for several kilometres, followed by the forcible injection of large amounts of water, chemicals and sand to release methane (otherwise known as natural gas). Canada is the fourth-largest producer and exporter of natural gas worldwide, and fracking is now the main method for production in Canada, with most of it occurring in British Columbia and Alberta. Both the leakage of methane as a potent greenhouse gas during the fracking process, and the possibility of exposure to hundreds of chemicals—some of which have known carcinogenic or hormone-disrupting activity—have potentially major implications for population health.

Of particular concern is the fact that fracking in Canada predominantly takes place in rural and Indigenous communities, and the absence of Canadian research in this field is another example of health inequity between our Indigenous and non-Indigenous populations. Research into the local health impacts of resource extraction, with a focus on impacts on Indigenous populations, is one of the priority recommendations of the 2017 Lancet Climate Countdown Canadian Public Health Association briefing for Canadian Policymakers.

Whatever the reasons behind our collective blind spots in these areas of research, it is long overdue for our national and provincial health research funding bodies to begin to align policy with the climate health emergency. Over the past decade, strategic research investments by Canadian funding agencies have been made in a number of areas, including chronic diseases, primary care, frailty and patient-oriented research. Where is the funding callout for the health effects of climate change or the cumulative health impacts of fossil-fuel extraction in Northern communities? And if not now, then when?

Dr. Margaret McGregor is a family physician and health services researcher. She is a clinical associate professor at the University of British Columbia, Department of Family Practice, and a research associate at the Vancouver Coastal Health Research Institute’s Centre for Clinical Epidemiology & Evaluation and the UBC Centre for Health Services Policy Research. Her research interest is in the health care of frail seniors in primary care and community settings. @1mcg8

Dr. Stirling Bryan is an economist with a career-long specialization in health care. He is a professor in UBC’s School of Population & Public Health, and a senior scientist at Vancouver Coastal Health’s Centre for Clinical Epidemiology & Evaluation. In 2016, he was appointed Scientific Director for the BC SUPPORT Unit, a component part of B.C.’s Academic Health Sciences Network, focused on promoting patient-oriented research. @StirlingBryan

Dr. Penny Brasher (far right in photo) is a senior research scientist at Vancouver Coastal Health Research Institute’s Centre for Clinical Epidemiology & Evaluation and an associate member of the Department of Statistics at UBC. Dr. Brasher’s research interests include clinical research methodology, secondary use of administrative data and statistical education.

Dr. Courtney Howard (second from right in photo) is a UBC and McGill-trained emergency physician in Yellowknife and board president of the Canadian Association of Physicians for the Environment. Dr. Howard does research on the health impacts of wildfires in the subarctic and was first author on the Lancet Countdown 2017 Report: Briefing for Canadian Policymakers. @courtghoward

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6 comments

CynthiaJuly 25th, 2018 at 5:43 pm

I agree. We need more research to focus on the link between global warming and health. We are slow to recognize the benefits of vegetarian diet in diabetes. Vegetarian diet also prevents global warming. We need to study these connections more closely so we can develop policies to protect our environment as well as improving individuals health.

One of the most important and most threatened aspects of human health is food self reliability. In 2005 Metro Vancouver established an Agriculture Committee to prepare a food security plan for the region. The first thing we did was ask for an analysis of the situation in BC by the BC Ministry of Agriculture. The report BC’s Food Self-Reliance “Can BC’s Farmers Feed Our Growing Population” (2006) examined the means of providing a healthy diet locally. It recommended that an additional 92,000 hectares of prime farmland with access to irrigation would have to be brought into production. The Agriculture Committee held public meetings and workshops throughout the region and drafted a Regional Food System Strategy which was adopted by the Metro Vancouver Board in 2011 and the Committee was disbanded. Metro Vancouver staff subsequently drafted a Regional Food System Action Plan which was adopted in 2016.

In the meantime changes in climate and severe weather events have become more evident while threats to our farmland have increased significantly. Only 1.1% of BC can grow the vegetables we need. Loss of the most fertile farmland to industrial development, the Site C Dam, non farm and non food uses, and huge mansions and country estates are threats to a healthy diet and public health.
Harold Steves, Past Chair, Metro Vancouver Agriculture Committee

Thank you for your very important comment which is so often left out of these conversations! I live in Alberta where we grow vast quantities of canola-canola will not feed the world…..in fact most of the pesticides used on these crops are wiping out all insect life. There are many pressures on farmers – climate change, increasing costs of chemicals, damage to soil, loss of pollinators, loss of agricultural land, inability to access funding to start farming – all while we import food from nations facing serious drought, fires, at risk for earthquakes and hurricanes. One day the food truck will not arrive.

In addition to the comment I put in earlier, I think the most critical aspect is that this is an existential problem of extreme urgency, affecting not only health but all aspects of global life. From a health perspective we have to consider not only the socio/biological/physical consequences of CC but also that health care will have to adapt to functioning in an environment where broad based health care infrastructure may be failing and fiscal resources compromised. The need will be to maintain human health (cheaper) rather than to aim to restore individuals to health after the fact (considerably more expensive.)
Research in the area of CC&H needs to be at the fore of all research; not much point in looking at the latest cancer cure (and I have benefitted from that) when we may lack the ability to provide it.

I have spent a fair bit of time considering and teaching about Health and the Environment but am not involved in research (retired) so some of these suggestions may be inappropriate, but the following are ideas that might be considered
1. Perhaps the lack is due in part to the lack by granting agencies of suggested CC&H research areas. Granting agencies usually list their areas of priority for upcoming competitions, and if CC&H is not mentioned, then researchers will likely not proposed research projects. One does have a career to consider.
2. Researchers like to cover issues that are important to government and the public and while the government talks about CC, not much concrete action is apparent and I wonder if the government has given any indication to granting agencies that CC&H is/should be a priority.
3. Research often is ‘siloed’ and issues of CC&H are inherently systems oriented problems. Many researchers do not feel comfortable exploring areas outside their expertise; such research is risky and can compromise a researchers academic and career prospects, although personally I think that going into an area that is ‘unknown’ provides a wonderful opportunity to do fundamental research and to become a leader in the field.
4. It is an overwhelming problem and I think that any researcher looking to study CC&H needs to spend a lot of time learning about CC and how it could interact with health. One needs to spend some time thinking about their specific area of health expertise and the infrastructure that governs how it functions, (what it depends on that is derived from the natural world and also the logistics of how care needs are met and how they can be altered or distorted by some action of CC, such as major floods, or sea-level rise and the loss of easy transport or communications) or how CC can affects health demands. some the “daydreaming” and considering “what ifs” it is easy to see only the forest when we need to look at a somewhat smaller area of interest. I think looking at news reports on CC caused events elsewhere gives one ideas as to how health can be affected and how to transpose such issues to the Canadian context.
5. I helped to write the recently released CPHA document “Global Change and Public Health: Addressing the Ecological Determinants of Health” which provides a basis to help one understand the interrelationships of Health, Environment, Climate Change. It is written from a public health perspective, but much of it can be used in the general medical arena. It is a good summary of key issues in both climate change and environmental change and a close reading of this document could well lead to some good research projects and also provide the required basis of justification for the research.

This document is provided under the terms of a CreativeCommons Attribution Non-commercial Share Alike license. The terms of the license are available at: http://creativecommons.org/licenses/by-nc-sa/3.0/. Attributions are to be made to HealthyDebate.ca, a project under the direction of Dr. Andreas Laupacis, at the Keenan Research Centre, Li Ka Shing Knowledge Institute of St. Michael’s Hospital.